Who Suffers From Doctor Error?
There is a grim reality in the world of medicine. It is simply that doctors are human. They make mistakes just like the rest of us. I am quite sure I have never met a doctor who intentionally made the wrong decision, however at the end of the day, we are the ones who suffer when they do. My brother-in-law of blessed memory was raised to be a true English gentleman. He trusted all doctors implicitly. It is a British thing. It seems that I may have mentioned this before. This is of course, absurd. That is why people get second or third opinions. But we cannot do that for every decision. We usually only do so when surgery or serious treatments are involved.
Then there is our world, the world of spouses who care for their loved ones with Dementia and all its attendant issues. Decisions are made constantly. This week was no exception. After Hubby’s last fall which I wrote about in a previous chapter, The Blood Thinner Dilemma, a few days passed and the pain in his neck and shoulders was excruciating from the fall. I called upon our private geriatrician to come to the house. He is caring, responsible, and has been a wonderful life-saver on many occasions. After an at-home ultrasound which found problems in other parts of the body (which we are dealing with), the doctor suggested heat therapy, paracetamol/ Acamol, and Voltaren (Diclofenac) anti-inflammatory cream. Then, as an after-thought, he suggested that a half tablet of a 5 mg. Valium would relax the neck muscles and help hubby with the pain.
I once had a love affair with Valium. I took it every time I boarded a flight after having a near-death experience on a TWA cross-country non-stop that left me quite shaken. I have a large supply of leftover pills in my stock because I no longer can tolerate them. I heard the doctor’s recommendation and immediately was concerned. Our experience has been that adding new mind-altering drugs to those which are already administered on a regular basis can be a problem. Thus, I asked the doctor if we could add the half tablet to the specific prescriptions Hubby was already taking without fear of complications. He said it would be no problem. He was the specialist, not I. I trusted that he was correct. How much trouble can a half tablet of anything actually cause?
After the first half tablet was given on night number one, Hubby was manic, walking around, unable to sleep. We knew that it was the pain of the neck and shoulder as he found our touching the area intolerable. His aide was dealing with him all night long and she suffered from sleep deprivation the next day. Hubby then became lethargic. He slept a great deal and was unable to communicate well. The next night we tried again. Another very difficult night, but worse than that, Hubby seemed really drugged for the entire day that followed. He was unable to find the words he needed, feed himself or keep his eyes open. I decided to give reduce the quantity to a quarter of the Valium the next night. The next day was worse. I did not then understand that Valium builds up in the body and remains there for a long time. We were beginning to think that he was dying. He was on a downhill slide and it was quite frightening. I then had a hunch that the valium was mixing badly with Hubby’s other mood stabilizers. I made the decision to stop the Valium completely. Unfortunately, it also takes a considerable amount of time for this particular drug to leave the body. That night was still very difficult and the next day was even worse. Hubby now had progressed to screaming in agony of the pain in his head, and became furious at anyone in his path. He became aggressive and ordered me to “get his gun” so he could “kill the stupid girl.” He was talking about the aide that he adores! She was now his mortal enemy because she wanted him to take his anti-anxiety medicines. He utterly refused. Oh yes, by the way, Hubby does not now, nor did he ever, own a gun! That did not seem relevant to him at the time.
This was a very distressing situation. Hubby was holding his head as though it was about to split open. I called our private geriatrician who said he thought we should get Hubby a CT scan. Perhaps there was a bleed in the brain causing all the pain? He said we needed to know. Hubby had not taken his anti-anxiety medications for twelve hours. His prescription wears off in-four!. How were we to get him to swallow a pill when he was throwing them across the room in a fury?
That was a tough moment. If I was to take Hubby to get a CT scan, he would have to be restrained. He could not be touched in this condition. It was clearly impossible to do as we were told. I asked his doctor if there was a way to have someone come to our home to inject him with a calming agent. He gave me the number of a private nurse with whom I made contact. She could come later to give Hubby an injection if the pills continued to be impossible to administer.
Regarding the CT scan, my immediate question was “What if they do find a bleed? Would they do anything about it?” Of course, the doctor I was asking would not be making that decision, but I was fairly sure that they would do nothing at all for a 94-year-old gentleman in his condition. If I was right, why go and start this nightmare of a process? I had to make a decision. The decision was “No.”
Hubby fell asleep finally, from sheer exhaustion. He awoke about three hours later and said he was hungry. He had a totally different personality. The Valium had worn off and he was returning to his former self. He was no longer holding his head and screaming from the pain. The pain he was experiencing was caused by the medicines which caused psychosis, not from an internal bleed. We could have followed the doctor’s instructions, had Hubby restrained, taken him to the scan, had him totally manic, and all for nothing.
The minute he woke up, we gave him his normal calming pills and an hour later they took effect. He has not held his head for even one moment since then.
After breakfast, he asked for his music. He began singing along with Frank Sinatra and had no memory of the past few days. We, on the other hand, were like limp dishrags from the stress and lack of sleep. We suspected earlier that he might be dying and discussed the possibility. It was a horrid experience.
Doctors are human. They are not omniscient, and do their very best on our behalf. But at the end of the day, it is the patient and their caregivers who pay the price.
There are indeed times when a caring family member’s instinct and common sense must kick-in. Once again, rushing Hubby to a hospital to look for the magic cure which might take hours or days of hospital incarceration to be resolved is something to be contemplated without haste – weighing the pros and the cons. Another lesson learned, and not to be easily forgotten. At least not by me!
Postscript: This morning, I wrote to the doctor who was involved in this drama. I am very fond of him. I feel however, that we have an obligation to tell our doctors when they make an error. We owe it to other patients who might have the same experience one day. A gentle letter is sufficient. Anger or accusations are totally worthless. Hopefully others will forgive us our own mistakes one day.
